scholarly journals Assessment of the correlations between gait speed in post-stroke patients and the time from stroke onset, the level of motor control in the paretic lower limb, proprioception, visual field impairment and functional independence

2016 ◽  
Vol 30 (3) ◽  
pp. 5-16
Author(s):  
Mariusz Drużbicki ◽  
Grzegorz Przysada ◽  
Justyna Podgórska-Bednarz ◽  
Andrzej Kwolek ◽  
Teresa Pop ◽  
...  
Keyword(s):  
Motor Control ◽  
Visual Field ◽  
Lower Limb ◽  
Barthel Index ◽  
Gait Speed ◽  
Functional Independence ◽  
Stroke Onset ◽  
Lower Limbs ◽  
Stroke Patients ◽  
Post Stroke

Abstract Introduction: Gait recovery is one of the main objectives in the rehabilitation of post-stroke patients. The study aim was to assess the correlations between gait speed in post-stroke hemiparetic patients and the level of motor control in the paretic lower limb, the time from stroke onset, the subjects’ age as well as the impairment of proprioception and visual field. Materials and methods: This retrospective study was performed at the Clinical Rehabilitation Ward of the Regional Hospital No. 2 in Rzeszow. The study group consisted of 600 patients after a first stroke who walked independently. The measurements focused on gait speed assessed in a 10-meter walking test, motor control in the lower limb according to Brunnström recovery stages, proprioception in lower limbs, visual field as well as functional independence according to The Barthel Index. Results: The study revealed a slight negative correlation between gait speed and the subjects’ age (r = − 0.25). No correlation was found between mean gait speed and the time from stroke onset. On the other hand, gait speed strongly correlated both with the level of motor control in the lower limb (p = 0.0008) and the incidence of impaired proprioception. Additionally, a strong statistically significant correlation between the patients’ gait speed and the level of functional independence was found with the use of The Barthel Index. Conclusions: The level of motor control in the paretic lower limb and proprioception are vital factors affecting gait speed and functional independence. Patients with a higher level of functional independence demonstrated higher gait speed.

scholarly journals Assessment of test-retest reliability and internal consistency of the Wisconsin Gait Scale in hemiparetic post-stroke patients

2016 ◽  
Vol 30 (3) ◽  
pp. 41-53 ◽  
Author(s):  
Agnieszka Guzik ◽  
Mariusz Drużbicki ◽  
Grzegorz Przysada ◽  
Andrzej Kwolek ◽  
Agnieszka Brzozowska-Magoń ◽  
...  
Keyword(s):  
Motor Control ◽  
Internal Consistency ◽  
Lower Limb ◽  
Barthel Index ◽  
Gait Speed ◽  
Muscle Tone ◽  
Stroke Patients ◽  
Retest Reliability ◽  
Post Stroke ◽  
Test Retest Reliability

Abstract Introduction: A proper assessment of gait pattern is a significant aspect in planning the process of teaching gait in hemiparetic post-stroke patients. The Wisconsin Gait Scale (WGS) is an observational tool for assessing post-stroke patients’ gait. The aim of the study was to assess test-retest reliability and internal consistency of the WGS and examine correlations between gait assessment made with the WGS and gait speed, Brunnström scale, Ashworth’s scale and the Barthel Index. Material and methods: The research included 36 post-stroke patients. The patients’ gait was assessed with the use of the Wisconsin Gait Scale, gait speed with the use of walk test, the level of motor control in a paretic lower limb – according to Brunnström recovery stages, muscle tone in a paretic lower limb – according to modified Ashworth’s scale and functional independence was assessed using the Barthel Index. Gait was assessed with the use of the WGS twice, with a 7-day interval, by three experienced physiotherapists. Results: The analysis of internal consistency of the WGS revealed that the Cronbach’s α coefficient was high in the case of all the three raters and ranged from 0.85 to 0.88. It was noted that the coefficient of variation for all the comparisons was below 10%. When assessing the repeatability of the results, it was revealed that correlations between both measurements made by particular raters were very strong and highly significant. The WGS results significantly correlated with Brunnström scale, Ashworth’s scale and gait speed. Conclusions: It was concluded that the WGS has a high internal consistency and test-retest reliability. Also, significant correlations were found between gait assessment made with the use of the WGS and gait speed, level of motor control and muscle tone of a paretic lower limb. The WGS constitutes a promising tool for a qualitative, observational analysis of gait in post-stroke patients and allows for proper planning, monitoring and assessing rehabilitation results.

scholarly journals A Chinese Herbal Medicine, Tokishakuyakusan, Reduces the Worsening of Impairments and Independence after Stroke: A 1-Year Randomized, Controlled Trial

2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
Hirozo Goto ◽  
Nobuhiko Satoh ◽  
Yoshinori Hayashi ◽  
Hiroaki Hikiami ◽  
Yutaka Nagata ◽  
...  
Keyword(s):  
Herbal Medicine ◽  
Controlled Trial ◽  
Strength Function ◽  
Functional Independence ◽  
Lower Limbs ◽  
Favorable Effect ◽  
Control Group ◽  
Stroke Patients ◽  
Post Stroke ◽  
Significant Difference

In post-stroke patients, the recurrence of stroke and progression of impairments lead to a bedridden state and dementia. As for their treatments, only anti-hypertension and anti-coagulation therapies to prevent the recurrence of stroke are available. In Asia, post-stroke patients with impairments are often treated with herbal medicine. The present study evaluated the effectiveness of tokishakuyakusan (TS) in improving the impairment and independence in post-stroke patients. Thirty-one post-stroke patients (mean age = 81.4 years) were recruited and enrolled. Participants were randomly assigned to the TS group (n= 16) or non-treatment (control) group (n= 15) and treated for 12 months. Impairments were assessed using the Stroke Impairment Assessment Set (SIAS). Independence was evaluated using the functional independence measure (FIM). For each outcome measure, mean change was calculated every 3 months. The results were that impairments according to SIAS did not significantly change in the TS group. In contrast, SIAS significantly worsened in the control group. There was a significant difference between the two groups. In each term of SIAS, affected lower extremity scores, abdominal muscle strength, function of visuospatial perception, and so forth. in the TS group were better than those in the control group. Independence according to FIM did not change significantly in the TS group. In contrast, FIM significantly worsened in the control group. There was also a significant difference between the two groups. In conclusion, TS was considered to suppress the impairments of lower limbs and to exert a favorable effect on cerebral function for post-stroke patients.

scholarly journals Postural Assessment Scale for Stroke Patients in Acute, Subacute and Chronic Stage: A Construct Validity Study

Diagnostics ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 365
Author(s):  
Cecilia Estrada-Barranco ◽  
Roberto Cano-de-la-Cuerda ◽  
Vanesa Abuín-Porras ◽  
Francisco Molina-Rueda
Keyword(s):  
Construct Validity ◽  
Functional Independence Measure ◽  
Functional Independence ◽  
Assessment Scale ◽  
Validity Study ◽  
Stroke Patients ◽  
Chronic Stage ◽  
Post Stroke ◽  
Valid Instrument ◽  
Postural Assessment

(1) Background: Observational scales are the most common methodology used to assess postural control and balance in people with stroke. The aim of this paper was to analyse the construct validity of the Postural Assessment Scale for Stroke Patients (PASS) scale in post-stroke patients in the acute, subacute, and chronic stroke phases. (2) Methods: Sixty-one post-stroke participants were enrolled. To analyze the construct validity of the PASS, the following scales were used: the Functional Ambulatory Category (FAC), the Wisconsin Gait Scale (WGS), the Barthel Index (BI) and the Functional Independence Measure (FIM). (3) Results: The construct validity of the PASS scale in patients with stroke at acute phase was moderate with the FAC (r = −0.791), WGS (r = −0.646) and FIM (r = −0.678) and excellent with the BI (r = 0.801). At subacute stage, the construct validity of the PASS scale was excellent with the FAC (r = 0.897), WGS (r = −0.847), FIM (r = −0.810) and BI (r = −0.888). At 6 and 12 months, the construct validity of the PASS with the FAC, WGS, FIM and BI was also excellent. (4) Conclusions: The PASS scale is a valid instrument to assess balance in post-stroke individuals especially, in the subacute and chronic phases (at 6 and 12 months).

Abstract W P140: Post-stroke Oculomotor Abnormalities evident during Objective Eye Tracking but Not under Clinical Assessment

Stroke ◽  
2015 ◽  
Vol 46 (suppl_1) ◽  
Author(s):  
John-Ross Rizzo ◽  
Todd Hudson ◽  
Briana Kowal ◽  
Michal Wiseman ◽  
Preeti Raghavan
Keyword(s):  
Motor Control ◽  
Eye Movements ◽  
Eye Movement ◽  
Oculomotor Control ◽  
Healthy Controls ◽  
Visually Guided ◽  
Stroke Patients ◽  
Movement Execution ◽  
Post Stroke ◽  
Control Post

Introduction: Visual abnormalities and manual motor control have been studied extensively after stroke, but an understanding of oculomotor control post-stroke has not. Recent studies have revealed that in visually guided reaches arm movements are planned during eye movement execution, which may contribute to increased task complexity. In fact, in healthy controls during visually guided reaches, the onset of eye movement is delayed, its velocity reduced, and endpoint errors are larger relative to isolated eye movements. Our objective in this experiment was to examine the temporal properties of eye movement execution for stroke patients with no diagnosed visual impairment. The goal is to improve understanding of oculomotor control in stroke relative to normal function, and ultimately further understand its coordination with manual motor control during joint eye and hand movements. We hypothesized that stroke patients would show abnormal initiation or onset latency for saccades made in an eye movement task, as compared to healthy controls. Methods: We measured the kinematics of eye movements during point-to-point saccades; there was an initial static, fixation point and the stimulus was a flashed target on a computer monitor. We used a video-based eye tracker for objective recording of the eye at a sampling frequency of 2000 Hz (SR Research, Eyelink). 10 stroke subjects, over 4 months from injury and with no diagnosed visual impairment, and 10 healthy controls completed 432 saccades in a serial fashion. Results: Stroke patients had significantly faster onset latencies as compared to healthy controls during saccades (99.5ms vs. 245.2ms, p=0.00058). Conclusion: A better understanding of the variations in oculomotor control post-stroke, which may go unnoticed during clinical assessment, may improve understanding of how eye control synchronizes with arm or manual motor control. This knowledge could assist in tailoring rehabilitative strategies to amplify motor recovery. For next steps, we will perform objective eye and hand recordings during visually guided reaches post-stroke to better understand the harmonization or lack thereof after neurologic insult.

Abstract WP471: Significant Factors for Early Independent Toilet Activities in Acute Stroke Patients

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Yuki Sawada ◽  
Takahisa Mori ◽  
Yuna Hosaka
Keyword(s):  
Cognitive Function ◽  
Acute Stroke ◽  
Mmse Score ◽  
Multiple Logistic Regression Analysis ◽  
Early Discharge ◽  
Functional Independence ◽  
Lower Limbs ◽  
Stroke Patients ◽  
Trunk Control ◽  
Significant Factors

Introduction: Acute stroke patients have problems with toilet activities. Independent toilet activity in hospitalized patients is important for dischargee to home. Hypothesis: Lower limbs function, trunk control and cognitive function are important factors of early independent toilet activities and discharge to home within 7 days. Methods: We included acute ischemic stroke patients who 1) were admitted from June 2017 to May 2018 and 2) received early rehabilitation treatment. Patients with disturbed level of consciousness were excluded. Functional independence measure (FIM) scale of 6 or 7 was defined as independence and FIM scale of 5 or less as dependence. We evaluated Brunnstrom Recovery Stage (BRS) of arms, fingers and lower limbs, trunk control test (TCT), Mini-Mental State Examination (MMSE) and investigated significant factors of early independent toilet activities and discharge to home within 7 days. Results: One-hundred twenty-four patients met our inclusive criteria. Their average age was 75.8 years, male gender of 63.7%, median BRS of arms, fingers and lower limbs was 5, 5 and 5, median TCT score and MMSE score were 94 and 24.7, respectively. Fifty-three patients were independent in toilet activity and 73 patients were dependent. All patients with independent toilet activity discharged to home within 7 days. In independent and dependent toilet activity patients, an average age was 73.6 and 77.4 (p<0.05), median BRS of arms was 5 and 5 (p<0.01), median BRS of fingers was 6and 5 (p<0.01), median BRS of lower limbs was 5 and 5 (p<0.01), median TCT score was 100 and 61 (p<0.01), and median MMSE score was 27.8 and 22.5 (p<0.01), respectively. Multiple logistic regression analysis showed that MMSE score (p<0.01), TCT score (p<0.01), and BRS of lower limbs (p<0.05) were independent factors for independent toilet activity and discharge to home. Receiver operating characteristic (ROC) curve for early discharge to home demonstrated that cut-off values of MMSE score, TCT score and MRS of lower limbs were 27 or more, 87 or more and 5 or more, respectively. Conclusion: BRS as lower limbs function, TCT as trunk control and MMSE as cognitive function were important factors of early independent toilet activities and early discharge to home.

Abstract WP148: Functional Independence Score of Acute Stroke Patients Can Predict Favorable Clinical Outcome at 3 Months After Stroke Onset

Stroke ◽  
2018 ◽  
Vol 49 (Suppl_1) ◽  
Author(s):  
Takashi Johno ◽  
Hiroyuki Kawano ◽  
Masataka Torii ◽  
Hiroshi Kamiyama ◽  
Tatsuo Amano ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Acute Stroke ◽  
Functional Independence ◽  
Stroke Onset ◽  
Stroke Patients ◽  
Favorable Clinical Outcome

Efficacy of Multi Unani regimen in functional independence recovery of post stroke patients and #8211; A black-box design

Spatula DD ◽  
2016 ◽  
Vol 6 (1) ◽  
pp. 41
Author(s):  
Mohd Shahid ◽  
Iram Naaz ◽  
Noor Ahmed ◽  
Sabiha Fatima ◽  
Mansoor Siddiqui
Keyword(s):  
Functional Independence ◽  
Black Box ◽  
Stroke Patients ◽  
Post Stroke

Effects of gait rehabilitation with a footpad-type locomotion interface in patients with chronic post-stroke hemiparesis: a pilot study

2012 ◽  
Vol 26 (8) ◽  
pp. 686-695 ◽  
Author(s):  
Naoki Tanaka ◽  
Hideyuki Saitou ◽  
Toshifumi Takao ◽  
Noboru Iizuka ◽  
Junko Okuno ◽  
...  
Keyword(s):  
Pilot Study ◽  
Sample Size ◽  
Gait Speed ◽  
Chronic Stroke ◽  
Gait Rehabilitation ◽  
Stroke Patients ◽  
Timed Up And Go ◽  
Intervention Phase ◽  
Post Stroke ◽  
Locomotion Interface

Objective: We developed a footpad-type locomotion interface called the GaitMaster. The purpose of this pilot study was to examine the effects of gait rehabilitation using the GaitMaster in chronic stroke patients. Design: Randomized cross-over design. Setting: An outpatient department. Subjects: Twelve patients with chronic post-stroke hemiparesis. Intervention: In group A, patients underwent an ‘intervention phase’ followed by a ‘non-intervention phase’, whereas in group B, patients underwent the non-intervention phase first, followed by the intervention phase. In the four- or six-week intervention phase, participants underwent twelve 20-minute sessions of gait rehabilitation using the GaitMaster4. Main outcome measures: We measured gait speed and timed up-and-go test. Results: No differences between the two groups were observed in the baseline clinical data. For the combined groups A and B, the maximum gait and timed up-and-go test speeds improved significantly only in the intervention phase ( P = 0.0001 and P = 0.003, respectively). The percentages of improvement from baseline at the end of GaitMaster training were 16.6% for the maximum gait speed and 8.3% for the timed up-and-go test. The effect size for GaitMaster4 training was 0.58 on the maximum gait speed and 0.43 on the timed up-and-go test. Conclusions: This pilot study showed that gait rehabilitation using the GaitMaster4 was a feasible training method for chronic stroke patients. Calculation of the sample size indicated that a sample size of 38 participants would be adequate to test a null hypothesis of nil benefit additional to routine rehabilitation for chronic stroke patients in a future randomized controlled trial.

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